Knowledge, Perceptions, and Practices of MRSA Transmission Prevention among Acute Care Setting Healthcare Workers.

摘要

The purpose of this research is to explore knowledge, perceptions, and practices concerning MRSA transmission prevention among acute care setting healthcare workers (HCW) and to examine the relationships among knowledge, perceptions, and the demographic characteristics on practice adherence to the Centers for Disease Control and Prevention guidelines to prevent transmission of MRSA.;This mixed-method study utilized three components: 1) survey research on a 33 item validated questionnaire (N=276); 2) HCW interviews following a four question interview guide (N=26); and 3) direct blinded observations of HCW hand hygiene (N=104). Medical, nursing, allied health, and support staff were included.;Survey findings demonstrated high levels HCW's knowledge (98.1%) of precautions but moderated consistency in self-reported practices (gloving = 95.5%, gowning = 89.0%, hand hygiene = 95.1%, with overall adherence = 84.4%). In survey research, adherence reports were lower when participants observed their peers (gloving = 85.4%, gowning = 76.2%, hand hygiene = 76.7%, with overall adherence = 65.4%). Regarding measures of knowledge while alcohol rubs are the best, only 33.8% of HCW reported thinking that alcohol rubs are the most effective hand hygiene (HH) method. Also, MRSA will live on the surface for days and weeks, only 40.9% were aware of MRSA's viability. HCW group membership and education level were significant predictors for practice adherence ( p<0.015). Regarding perceptions, HCW's reported comfort with reminding others to gown and glove (85.1%) and to practice hand hygiene (78.8%). In Nursing Staff, self-efficacy, measured by comfort reminding others to gown and glove (Fisher's Exact p = .03), and perform HH ( p = .005) was a moderating predictor of practice. Findings from the blinded HH observations (84.6%) were lower than self-reported HH (95.1%) with Support Staff having the greatest discrepancy. Communication was the most influential barrier (30.2%). Education was the dominant comment provided on the survey (N =85) with an additional 41 comments during interviews. Interview findings demonstrated HCW's positive awareness and responsibility in transmission prevention with minimal barriers.;While HCWs have knowledge regarding guidelines and report practice adherence, they also recognize deficient prevention practices in peers. A gap between knowledge and practices exists. Reported HH adherence is higher than observed HH. Self-efficacy, HCW group, and education are predictor of practice adherence. Education on epidemiological factors supporting practice is recommended to promote hand hygiene adherence.